Ranulas: possible signs for HIV/AIDS? 1 year Ugandan descriptive study

Abstract

Introduction. Certain oral manifestations signal progression of HIV disease among HAART naïve patients or an increase in the plasma HIV-1 RNA levels for those on treatment. Ranulas may be one of those manifestations. Therefore, this study describes the clinical features of patients who presented with ranulas including their demographics, HIV sero-status and the CD4 CD8 cell counts for those who were HIV positive. Methods. A prospective study on ranulas was undertaken at Mulago national referral hospital and St Mary's hospital Lacor covering the period December 2008 to November 2009. Results. Fifty-seven cases participated in the study: 38.6% male and 61.4% female. Out of the study group, 73.7% were HIV positive. This was statistically significant (Chi = 12.789, df = 1, p = 0.001). In relation, to CD4 cell count, 23.8% had <200 cells/mm³, 35.7% between 200–500 cells/mm³ and 40.5% more than 500 cells/mm³. The CD4-to-CD8 ratio ranged from 0.02–0.98 with an average of 0.31 ± 0.23, median and mode of 0.27 and 0.32, respectively. Conclusions. It is felt that ranulas may be one of the oral manifestations of worsening immunity in HIV/AIDS disease. Therefore, more research is needed to establish if it should be included among known oral manifestations of the disease.

Key Words::

• ranulas
• HIV
• AIDS
• Mucocele
• salivary gland disease

Acknowledgement

We are grateful to all our colleagues at Infectious diseases institute, Baylor college of medicine Uganda, Mild May, Kamokya Christian care centre, HIV AIDS care centers at Mulago and St Mary's hospital Lacor, Makerere Mbarara university Joint AIDS program for all the assistance rendered in carrying out HIV/AIDS tests and CD4 and CD 8 cell counts.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.